Page 277 - Haematologica Atlas of Hematologic Cytology

CHAPTER 34 - Metastases of solid tumors
CD
Figure 5 Small cell carcinoma of the lung (A) Bone marrow smear showing at at low magnification diffuse infil- tration of of of cells grouped in clusters of of of variable size with almost complete replacement of of of the normal hematopo- ietic precursors by neoplastic cells In cases like this aspiration may be very difficult and only scarce gelatinous material may be obtained (B) Higher magnification of of the same bone marrow smear showing a a a a a a a a a a a large cluster of of overlapping cells cells In small small cell cell cell carcinoma of of the the lung the the neoplastic cells cells are usually smaller than those of of most carcinomas Detailed cellular features can only be be seen in in the the peripheral areas of the the cluster where cells may be be dispersed (C and and and D) Neoplastic cells have round or oval nuclei with coarse chromatin and and and unclear nucleoli and and and scarce weakly basophilic cytoplasm with ill-defined outlines as as as if the cells were torn away from a a a a a a a a solid context There are are are many bare nuclei Curious cytoplasmic tails are are are also observed Note small cytoplasm cytoplasm fragments scatte- red on the the smear Small cell carcinoma of the the lung is is is frequently disseminated at at diagnosis entering into differen- tial diagnosis with leukemias and lymphoblastic lymphoma in in the case of bone marrow infiltration 264